<%@ page language="java" contentType="text/html; charset=UTF-8"
	pageEncoding="UTF-8"%>
<%@ taglib prefix="c" uri="http://java.sun.com/jsp/jstl/core"%>
<%@ taglib prefix="fmt" uri="http://java.sun.com/jsp/jstl/fmt"%>
<c:set var="ctx" value="${pageContext.request.contextPath}" />
<form action="${ctx}/patient/submit.do" method="post">
<fieldset><legend>接诊信息</legend>
<ul>
	<li><label for="patientName">日&nbsp;&nbsp;&nbsp;期：</label><input
		class="Wdate" type="text" id="datePicker"
		onFocus="WdatePicker({isShowClear:false,readOnly:true})" /></li>
	<li><label>医&nbsp;&nbsp;&nbsp;生：</label><span
		style="position: absolute; overflow: hidden"><select
		name="doctorId">
		<option value="-1">请选择医生</option>
		<c:forEach var="doctor" items="${doctors}">
			<option value="${doctor.doctorId}">${doctor.doctorName}</option>
		</c:forEach>
	</select></span></li>
</ul>
</fieldset>
<fieldset><legend>患者基本资料</legend>
<ul>
	<li><label>姓&nbsp;&nbsp;&nbsp;名：</label><input name="patientName"
		type="text" class="input" /></li>
	<li><label>年&nbsp;&nbsp;&nbsp;龄：</label><span
		style="position: absolute; overflow: hidden"><select
		name="patientAge">
		<c:import url="../include/option_age.jsp" />
	</select>&nbsp;岁</span></li>
	<li><label>民&nbsp;&nbsp;&nbsp;族：</label><span
		style="position: absolute; overflow: hidden"><select
		name="patientNation">
		<c:import url="../include/option_nation.jsp" />
	</select></span></li>
	<li><label>职&nbsp;&nbsp;&nbsp;业：</label><input name="patientJob"
		type="text" class="input" /></li>
	<li><label>手&nbsp;&nbsp;&nbsp;机：</label><input
		name="patientMobile" type="text" class="input" /></li>
	<li><label>电&nbsp;&nbsp;&nbsp;话：</label><input name="patientPhone"
		type="text" class="input" /></li>
	<li><label>地&nbsp;&nbsp;&nbsp;址：</label><input
		name="patientAddress" type="text" class="input" size="50" /></li>
</ul>
</fieldset>
<div style="text-align: center;"><input type="submit"
	value="确&nbsp;&nbsp;&nbsp;定" class="submit" />&nbsp;&nbsp;<input
	type="reset" value="重&nbsp;&nbsp;&nbsp;置" class="reset"></div>
</form>
<script type="text/javascript">
	$(document).ready(function() {
		var today = new Date();
		var day = today.getDate();
		var month = today.getMonth() + 1;
		var year = today.getYear();
		var date = year + "年" + month + "月" + day + "日";
		$("#datePicker").val(date);
	});
</script>
